JILL A RUSSELL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028325

License Status

EXPIRED

Business

First Name

JILL A

Last Name

RUSSELL

Business Name

JILL A RUSSELL

Original Issue Date

05/26/1992

Effective Date

05/26/1992

Expiration Date

06/30/1995

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006